
COLD J 



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For the Use of its Policy Holders 



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(COMMISSIONS^ 

STANDARDS 

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STANDARDS of HEALTH 
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ST ANDARDS for CLEAN BARNS 
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STANDARDS FOR 
^£LEAN HANDLING^ 

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Copyright, 1914 
By the Metropolitan Life Insurance Co. 



All About Milk 



BY 

MILTON J. ROSENAU 

Professor of Preventive Medicine and Hygiene, Harvard University 

Formerly Director of the Hygienic Laboratory 

U. S. Public Health Service 




PRINTED AND DISTRIBUTED BY THE 

METROPOLITAN LIFE INSURANCE COMPANY 

FOR THE USE OF ITS POLICY -HOLDERS 
1914 




Courtesy of the Chicago Health Department] 



S)CI.A381046 

AUG 31 1914 



All About Milk. 



Why Do We Have a Milk Question?— Because milk is apt 
to be dangerous to health. 

Why is Milk Apt to be More Dangerous to Health Than 
Other Animal Food? — Because it is mostly taken raw, while 
nearly all other animal food is cooked. Thorough cooking 
kills the harmful germs. 

Did Nature Intend Us to Use Cow's Milk?— No. Milk 
was never intended by nature to be drawn into a pail, emptied 
into a can, carted to town, and placed in bottles which are left 
on the doorstep next morning. Further than this, cow's milk 
is often exposed to dust, flies and dirt, and frequently it is not 
used until it is two or three days old. Such stale, germ-laden 
milk may be quite injurious to the baby. 




What is the Advantage of Nature's Plan? — In nature's 
plan the milk is taken directly at its source while pure, fresh, 
sweet, clean and wholesome. Milk was never intended to see 
the light of day. Nature's plan keeps out dirt, germs, flies 
and fevers. A breast-fed baby need not fear stale and partly 
decomposed milk, containing dirt and germs. The short haul 
is God's plan. The long haul is a poor substitute. 



Page Four 



ALL ABOUT MILK 



MILK AS A FOOD. 
What is the Food Value of a Quart of Milk? — One quart of 
milk is about equal in food value to any one of the following : 



2 pounds of salt codfish. 

3 pounds of fresh codfish. 
2 pounds of chicken. 

4 pounds of beets. 

5 pounds of turnips. 
\ pound of butter. 

\ pound of wheat flour. 

| pound of cheese. 

f pound of lean round beef. 

8 eggs. 

2 pounds of potatoes. 

6 pounds of spinach. 

7 pounds of lettuce. 
4 pounds of cabbage. 




1 QUART OF 
COSTING 8 OR 



MILK 
10 CTS. 



8 EGGS COSTING 
25 TO 30 CTS. 



What is the Food Value of a Glass of Milk? 

2 large eggs, 



A glass of milk is about equal to 



a large serving of lean meat, 

2 moderate-sized potatoes, 

5 tablespoonfuls of cooked cereal, 

3 tablespoonfuls of boiled rice, or 
2 slices of bread. 



Is Milk a Cheap Food? — Milk is one of the cheapest foods 
on the market. It is also one of the most easily digested. It 
is very nourishing, and may be served in a number of different 
ways, as custards, puddings, sauces, cream, ice cream, cheese, 
etc. Milk and milk products make up about one-sixth (16%) 
of all food eaten by the average American family. 

Is Milk Readily Tainted? — Milk absorbs odors and flavors 
just as charcoal does. It will soon taste of tobacco, onions, 
fish or fruit if exposed to these things in an open pitcher or 
bottle. Turnips, onions and other strong-tasting substances 
fed to the cow will also give a flavor to the milk. 

Milk should have no odor at all, or at most a slight charac- 



ALL ABOUT MILK 



Page Five 



teristic odor. A "cowy" odor means smelly barns, poor dairy 
methods and tainted milk. 

Does Milk Decompose Readily? — Milk decomposes more 
readily than any other food. It spoils even more quickly than 
fresh fruit and berries. It is the most difficult of all our food 
stuffs to collect, handle and transport in a safe and satisfactory 
manner. It requires the greatest care from pasture to pail, 
and from pail to palate. 

Is All Milk Dangerous? — No. But there is no easy way 
of telling the good from the bad. Most of the dangers in 
milk may be avoided by pasteurization. 

Is Milk Apt to Contain More Impurities than Drinking 
Water? — Water conveys only a few diseases — typhoid fever 
mainly; milk conveys many diseases — tuberculosis, scarlet 
fever, diphtheria, septic sore throat, typhoid fever and summer 
complaints of babies. Bacteria, as a rule, soon die in water, 
while they grow and multiply in milk. 

Is Milk More Dangerous than Other Foods? — Milk is 
responsible for more sickness and more deaths than all other 
foodstuffs put together. 

How Should Milk be Cared for in the Home? — Milk should 
not be allowed to stand out of doors, but should be taken in 
as soon as it is delivered. 




ONE OF THE THINGS THAT MAY HAPPEN TO MILK DURING THE EARLY 
HOURS OF THE MORNING. 

The milk bottle should be protected in a box until taken into the house, 
and placed on ice as soon as possible. 



Page Six 



ALL ABOUT MILK 




What is "Dip 
milk" is milk dipped from a can. 
It is also called "bulk milk." Milk 
is often sold in this way at grocery 
stores and small shops. The best 
qualities of milk are never sold in 
bulk, but always in individual 
bottles. Dip milk is therefore pretty 
sure to be the poorest grade. 

What Special Care Should be 
Taken with the Milk Bottle?— Milk 
should never be placed in a bottle 
that has not been disinfected by 
scalding with boiling water. Milk 
bottles should not be taken into 



In the home milk should be kept 
cold, clean and covered. If part of 
the milk in a bottle is used, do not 
replace the paper stopper, but invert 
a clean tumbler over the neck of the 
bottle and at once replace in the ice- 
chest. Never let the milk bottle stand 
around. Have a special place in the 
coldest part of the ice-chest for the 
milk bottles. The best way is to have 
the milk bottle touching the ice.* 

What is the Advantage of the In- 
dividual Bottle? — Cleanliness and pro- 
tection from dirt, flies, fingers and 
germs. If it is well to sell crackers and 
cereals in individual packages, surely 
milk should be sold in the same way. 

Milk"?— "Dip 




*A cheap, home-made ice-box for milk can easily be made by follow- 
ing the directions given in a pamphlet issued by the Metropolitan Life 
Insurance Company entitled "The Child," page 13. 



ALL ABOUT MILK 



Page Seven 



the sick-room. They should never be used for any other pur- 
pose than to hold milk. They should always be rinsed in cold 
water and then thoroughly washed and scalded before they are 
returned to the milkman. Never take milk from a dairyman who 
does not disinfect his milk bottles with boiling water or steam. 




BOTTLES WASHED BY HAND. SUCH BOTTLES MUST SUBSEQUENTLY BE 

SCALDED OR STEAMED, FOR THE HANDS CANNOT STAND WATER 

HOT ENOUGH TO DISINFECT THE BOTTLES. 



How Much Milk is Used? — Ten billion gallons a year 
in this country alone ; this would make a lake large enough to float 
the navies of the world. Only about one-quarter of this vast 
amount is used as milk; the other three-quarters go into butter 
and cheese. Each person in the United States uses on an 
average about half a pint of milk a day. 

Should Milk Dealers be Licensed? — It is more important 
to license persons engaged in the milk industry than it is to 



Page Eight 



ALL ABOUT MILK 



license plumbers, undertakers or trained nurses. New York, 
Washington, Boston and other cities require all persons who 
handle milk to obtain an official license or permit from the 
health authorities. 

Such a system helps the inspector to get cleaner dairies 
and to get rid of sickly cows, and makes it easier to enforce 




MILK BOTTLES BEING PILLED AND CAPPED BY MACHINERY. 
THE BEST METHOD. 

the milk regulations and to improve the supply. It is to the 
interest of every householder that the milk supply should be 
Carefully supervised. Is your milkman licensed? Are his 
dairies inspected? 

How is Milk Made? — Milk is formed directly from the blood 
and contains many of its important substances. Some of these 
pass unchanged from the blood into the milk. Others, however, 
are very much changed. 

The breasts or udders are factories receiving blood as a raw 
product and delivering milk as the finished product. 



ALL ABOUT MILK 



Page Nine 



Of What Special Importance is the Fact That Milk is 
Formed Directly from the Blood? — The blood contains special 
substances which guard us against infectious disease. Some 
of these substances pass from the blood into the milk and are 
of benefit to the nursing baby. For instance, mother's milk 
may contain the antitoxin of diphtheria which protects the 
baby. Nursing infants rarely have diphtheria. Cow's milk 
does not contain diphtheria antitoxin because cows are not 
subject to diphtheria. Mother's milk contains other protecting 
substances or guards for the baby that are not found in cow's 
milk; hence a bottle-fed baby is deprived of the natural pro- 
tection which is found only in the mother's milk. 

Does the Milk of One Animal Differ Very Much from the 
Milk of Another? — There is a general resemblance between 
the milk of all animals, but this resemblance is superficial only, 
for there are some very marked differences. The milk of whales 




DIRTY FLANKS. A COMMON CONDITION IN WINTER. FLANKS BECOME CAKED 

WITH MANURE, WHICH IS OFTEN NOT REMOVED. THIS IS THE 

SOURCE. OF MUCH OF THE DIRT FOUND IN MILK. 



Page Ten 



ALL ABOUT MILK 



differs very much from the milk of goats, the milk of goats is 
quite different from that of dogs, and the milk of cows is different 
from that of women. 

Is the Milk of Any Other Animal Than the Cow Used as 
Food? — While we are accustomed to cow's milk, the milk of 
other animals is preferred in some parts of the world. In Italy 
and other countries goat's milk is preferred. In certain parts 
of Europe asses' milk is much used; even the milk of mares, 
buffaloes and camels is made use of. 




CLEANING COWS PREPARATORY TO MILKING. A SIMPLE OPERATION REQUIR- 
ING NO OTHER OUTLAY THAN A LITTLE TIME AND SOME CLEAN 
WATER. THE BUCKETS CONTAIN CLEAN WATER. 

Is There Any Advantage in Goat's Milk? — Goat's milk is 
cheaper than cow's milk, although a fairly good goat will yield 
only about two quarts of milk daily. Still more important is 
the fact that goats rarely have tuberculosis ; hence this danger 



ALL ABOUT MILK Page Eleven 

is at once eliminated. In our country there is an unreasonable 
prejudice against the humble goat, which is sometimes called 
the "poor man's cow." 

Could We Get Along Without Cow's Milk?— There are 
some nations, as for example China and Japan, with millions 
of people, who get along pretty well without cow's milk or the 
milk of any other domestic animal. Chinese and Japanese 
babies are nursed by their mothers somewhat longer than in 
this country, and are weaned gradually upon cereals, grains 
and a mixed diet. With our habits and customs, it would be 
a serious matter to be deprived of cow's milk. 

Does Milk Contain Life? — Milk is a vital fluid, but it is 
not alive. In fact, milk is dead and begins to spoil from the 
moment it is drawn; just as blood decomposes soon after it is 
shed. The only live things in milk are the bacteria, and they 
are very much alive. 

Why Did Our Parents Hear Nothing about the Dangerous 
Bacteria in Milk When They were Young? — Because the 
dangers were not realized until recent years. Even after the 
tuberculosis germ was discovered in 1882, it took a long time 
before it was found that these bacilli (germs) often contaminate 
milk. The same story is true for typhoid bacilli, diphtheria 
bacilli, and other infectious germs. 

We often hear people say, "Took at me! I am hale and 
hearty at eighty years. I have always been fond of milk, and 
it has never hurt me." Such people forget that the fruits of 
victory cannot be measured by the survivors alone — we must 
have the list of the killed and wounded too. More victims have 
fallen as a result of infected milk than as a result of bullets in war. 

COMPOSITION OF MILK. 

Is Milk a Simple Substance? — No. It is very complex. 
It contains the chief parts of all the different foods commonly 
found on the table. 

What Foods Will Milk Take the Place of?— Milk is equal to a 
meal consisting of meat and eggs, sugar and cereals, oils and fats, 



Page Twelve ALL ABOUT MILK 

with salt and water. A milk diet therefore is like a mixed diet. 
Milk alone contains all the elements necessary to sustain life. 

What Does Milk Consist of? — Milk consists of five chief sub- 
stances: 1. Albumin like the white of egg. 

2. Sugar like cane sugar. 

3. Fat like butter. 

4. vSalt like common table salt. 

5. Water. 

Milk also contains cells, ferments, gases, antitoxins and 
other important substances. 

Does Milk Contain Much Water? — Milk is a very watery 
or dilute food. A pint of milk, weighing 16 ounces, is made up 
of about 14 ounces of water and 2 of solids. More precisely, 
about 87 per cent, of milk is water; the remaining 13 per cent, 
consists of solid substances, such as albumin, sugar, fat and salt. 




mother's milk. 

Does the Milk of All Cows Have the Same Amount of 
Water?— No. Holstein cows usually yield a more watery 
milk than Jerseys or Guernseys; otherwise the milk of Holstein 
cows is quite as wholesome and nutritious as the others. 

Is Milk Often Watered?— This mode of adulterating milk used 
to be practised, but is less common now, for it is very easy for the 
health officer to detect milk that has had water added to it. 



ALL ABOUT MILK Page Thirteen 

ALBUMIN. 

What is Albumin? — Albumin is a substance like the white of 
egg or the lean of beef. There are many different kinds of albumin. 

What Kind of Albumin is Found in Milk? — Chiefly casein. 
This is a very important part of milk because it readily sepa- 
rates out. When this happens the milk curdles. 

How Much Albumin Does Milk Contain? — Cow's milk 
contains 4.5 per cent., mother's milk only 1.5 per cent. Further- 
more, the albumins in cow's milk are mostly casein, while 
mother's milk contains very little casein. 

Cow's milk contains much more albumin than mother's 
milk, because the calf is larger and grows much more rapidly 
than the infant; thus nature has provided a food especially 
fitted to suit the young of each animal ; therefore, the milk of 
the cow may not be at all suitable to nourish the infant. 

Why is Cow's Milk Usually Diluted for the Baby? — Because 
cow's milk contains about three times as much albumin as 
mother's milk. The two milks differ further, not only in 
amount of albumin, but in the kind of albumin they contain 

Has This Any Importance in Infant Feeding? — This is 
important because the albuminous matter forms curds, and 
some curds are more readily digested than others. Milk 
curdles as soon as it reaches the stomach. 

What is the Danger of Too Much Albuminous Matter? — ■ 
If cow's milk is not diluted the baby is placed in the position 
of a person living upon a rich meat diet. Too much meat leads 
to putrefaction in the intestines, just as too much albuminous 
matter in milk may be the source of indigestion and colic, which 
lead to summer complaint. 

What is the Scum that Forms on the Surface of Milk When 
It is Heated? — This scum, or skin, is a little thickened albumin. 
The same thing takes place when an egg is boiled — the albumin 
thickens and hardens. The scum on milk is not harmful. 
It will not form if the vessel in which the milk is heated is well 
covered. 



Page Fourteen ALL ABOUT MILK 

SUGAR OF MILK. 
What is Sugar of Milk? — A sweetish substance like cane 
sugar. Sugar of milk is found nowhere else in nature. It is 
called lactose. 

How Much Sugar Does Milk Contain? — Cow's milk con- 
tains only about 4^ per cent., mother's milk 7 per cent. — almost 
twice as much. Hence sugar is usually added to cow's milk 
when the bottle is being prepared for the baby. 

What is the Special Use of the Milk Sugar in the Body? — 
It is oxidized or burned in the body; hence it warms our 
bodies and keeps up the blood heat; it also furnishes "steam" 
to make the machine work. It serves as fuel to yield force 
and energy in the form of heat and muscular power. 

Will Too Much Sugar Harm the Baby? — There is a tempta- 
tion to add sugar generously to the milk for the bottle-fed baby, 
for the reason that sugar is fattening. It is a pleasure to see 
a chubby baby, but an over-fat baby is not a sign of robust 
health. Milk should not contain more than the 7 per cent, of 
sugar which is provided by nature. Too much sugar may set 
up fermentation in the intestines and lead to trouble. 

Just What Happens When the Milk Sugar Ferments? — 
When milk sugar ferments it is changed into an acid. The 
acid thus formed causes the milk to turn sour and curdle. 

What Causes Milk Sugar to Ferment? — Bacteria or germs. 

Can All Bacteria Ferment Milk Sugar? — No, only certain 
kinds known as lactic acid bacteria, which have the power of 
converting milk sugar, or lactose, into lactic acid. 

Why Does Milk Turn Brown When Boiled a Long Time?— 
Because some of the milk sugar is turned to caramel. This 
change is not harmful but unnecessary. 

FAT. 
How Does the Fat Exist in Milk? — In the form of very fine 
droplets. These little fat droplets are lighter than the milk, 
hence rise and float on the surface, just as oil floats on water. 



ALL ABOUT MILK 



Page Fifteen 




FAT DROPLETS IN MILK. 



How Much Fat Should Milk Contain? — Mother's milk 
usually contains about 4 per cent.; cow's milk varies from 3 to 
5 per cent. The law in almost all States requires cow's milk 

to contain not less than 2>}/2 per cent, 
of milk fat, sometimes spoken of as 
butter fat. 

What is Butter? — Butter consists 
of the fat drops which have run to- 
gether when cream is churned. 

What is Cream? — Cream is milk 
rich in fat — not pure fat. It contains 
all the elements of milk. Cream is 
simply "top milk," as it is often 
called. Cream varies greatly in richness. A heavy cream 
contains 40 per cent, or more of fat, a medium cream about 
20 to 30 per cent., and a light cream from 13 to 16 per cent. 
Can the Richness of Milk be Judged by the Cream Line? — 
Not always. The cream line is destroyed by heating or shaking. 
The cream rises rapidly in a watery 
milk. A narrow-necked bottle of thick 
glass gives the false impression of a 
long column of rich cream. 

Is There Any Sanitary Difference 
Between Cream and Milk? — When the 
fat drops rise in milk they sweep the 
milk very much as a snowstorm sweeps 
the air. That is, the fat drops carry 
along with them many bacteria ; there- 
fore cream contains many more bac- 
teria than the milk from which it is 
taken. As top milk or cream is often 
used to prepare modified milk for in- 
fant feeding, you will see how neces- 
sary it is to start with a milk of good false impression op much 

J . ° CREAM BECAUSE OP 

quality. narrow neck. 




Page Sixteen 



ALL ABOUT MILK 



What is Skim Milk? — When the fat or cream is removed 
from milk, what is left is called skim milk. The only difference 
between the two is the fat. 





SKIM MILK. 



whole; milk. 



Is Skim Milk Nutritious? — Yes. It contains all the albumin, 
sugar, salts and other valuable parts of milk. It is simply 
milk without its fat. Skim milk is wholesome, nutritious and 
cheap. It is the cheapest form of albumin on the market. In 
order to be safe, skim milk must be obtained from pure milk. 

Is a Very Rich Milk Good for the Baby?— No, it is harmful. 
Too much fat causes indigestion and a sort of self-poisoning, 
leading to diarrhea and summer complaint. 

What Kind of Salt Does Milk Contain?— Milk contains 
the salts of lime, potash and soda, as well as phosphates, small 
quantities of magnesia, and traces of iron. These salts are of 
very great importance. They are, in fact, necessary to life. 

How Much Salt Does Milk Contain? — Cow's milk contains 
0.75 per cent.; mother's milk, 0.2 per cent. That is, cow's 
milk contains almost four times as much of these salts as 
mother's milk. 

What are Ferments? — They are highly important sub- 
stances found in all living things. They are exceedingly active 
and very important. Milk contains a number of ferments. 



ALL ABOUT MILK Page Seventeen 

Pepsin is a ferment. When an apple is cut open and left 
standing it soon becomes discolored. This is due to a ferment 
in the apple which becomes active when exposed to the oxygen 
of the air. All fruits and vegetables contain ferments. All 
animal tissues also contain these active substances. 

Where Do the Ferments in Milk Come From?— Some of 
them are in the milk as it leaves the udder. Some of them 
develop in the milk as a result of the growth and multiplication 
of bacteria. The bacteria secrete various kinds of ferments. 

Is It Possible to Modify Cow's Milk So As to Resemble 
Mother's Milk? — Yes, to resemble it, but never to be "just as 
good." It is impossible to change cow's milk into mother's 
milk. By diluting cow's milk and adding sugar we can make a 
mixture that is something like mother's milk, but always lack- 
ing important substances. 

Can This Deficiency be Made Up? — In part, by giving the 
baby barley-water and orange-juice. 

Is a Bottle-fed Baby Handicapped? — Yes; seriously. The 
cow is a good foster-mother, but a foster-mother only. Mother's 
milk is fresh, clean and pure; cow's milk is apt to be stale, 
dirty and injurious. 

SOURING AND CURDLING OF MILK. 

What is the Curd? — When milk curdles, very much the same 
thing takes place as when an egg is heated; the albuminous 
matter is rendered hard, lumpy and insoluble. The curd is the 
thickened casein which separates out of milk. 

Why Does Milk Turn Sour and Curdle? — The bacteria 
growing in milk produce an acid which turns it sour, and the 
acid acts on the albuminous matter, causing it to thicken. 

Will Anything Else Curdle Milk? — Yes, rennet. Rennet 
is the ferment found in the gastric juice; hence the first thing 
that happens to milk when it reaches the stomach is to become 
curdled. The curd is then acted on by the pepsin and digested. 
If the lumps are large and tough, the digestion is slower than if 
the lumps are soft and small. 



Page Eighteen ALL ABOUT MILK 

Is There Any Difference Between an Acid Curd and a 
Rennet Curd? — No essential difference, except that the acid 
curd is sour on account of the acid, whereas the rennet curd 
is sweet. The curd itself is alike in both instances. The sweet 
curd is called clabber. Buttermilk usually contains acid curd. 

Is There Any Difference Between the Curd of Cow's Milk 
and Mother's Milk? — A very marked difference. The curds 
from cow's milk are tough, large, lumpy and as hard to digest 
as a hard-boiled egg. The curds from mother's milk are soft, 
small, flaky, and as easy to digest as a soft-boiled egg. 

Is Curdled Milk Healthful or Injurious? — Curdled milk 
obtained from pure milk is just as wholesome and nutritious 
for grown-up people as fresh milk. Curdled milk should not 
be used for babies except when advised by a physician. 

ABNORMAL MILK. 

Does Milk Sometimes Have an Abnormal Color? — Milk may 
be red on account of the presence of blood. The blood may 
come either from an injury to the udder or from an inflam- 
mation^ Cows feeding on colored plants, such as madder 
root, will secrete a colored milk. The red color which develops in 
milk upon standing is due to the growth of a red germ. Milk 
sometimes turns blue from the growth of a germ of that color. 

What is Slimy or Ropy Milk? — Substances resembling 
mucilage sometimes develop in milk. This change is due to 
bacterial action. The milk may get so slimy that hV can be 
drawn into threads ten feet long and as thin as a spider-web. 
In Norway such milk is considered a delicacy. It has no 
injurious properties, but it is objected to in this country. 

What is the Cause of a Bitter Taste in Milk?— The milk 
may be bitter when freshly drawn, or may develop this taste 
on standing. In the first instance the bitter taste is usually 
due to the fact that the cows have fed on bitter herbs, such 
as wormwood, turnips, cabbages, etc. When the bitter taste 
develops in milk some hours after it has been drawn, it is due 
to a putrefactive change caused by the growth of bacteria. 



ALL ABOUT MILK 



Page Nineteen 



When milk has a bitter taste with a soft, slimy curd, it shows 
that abnormal decomposition has taken place. Bitter milk 
should never be used ; it may be dangerous. 

Why is Bitter Milk Apt to be Dangerous? — Because it may 
contain the so-called ' ' ptomaines. ' ' At least it contains bacteria 
that are said to produce ptomaines. 

Does Milk Ever Contain Drugs? — A large number of drugs 
taken in through the mouth have been found in the milk of 
nursing mothers, such, for example, as mercury (calomel), 
antipyrine, opium, purgative salts, rhubarb, arsenic and 
potassium bromide. Every nursing mother knows how care- 
ful she must be with her diet in order not to affect the baby. 

Cows are good botanists, but their judgment cannot be 
relied upon so far as the baby is concerned. Cows in pastures 
sometimes feed upon objectionable or poisonous weeds. Some 
of these poisons may pass into the milk. A cow that is kept 
to produce certified milk, which is the best grade of milk for 
babies, is not, under any circumstances, allowed to graze in 
the pasture on account of this danger. Such cows are given 
selected feed in suitable amounts. 

DIRTY MILK. 
Is Milk Often Dirty? — Yes, very often. Frequently it 
contains so much dirt that the specks may be seen as a sediment 
in the bottom of the bottle or glass. Ordinarily the dirt cannot 
be seen because the dairyman has filtered the milk or taken 
out the dirt in a special machine called a clarifier. Filtration 




TWO KINDS OF MILK PAILS. THE OPEN PAIL ADMITS THE DIRT; THE COVERED 
PAIL KEEPS MUCH OP IT OUT. 



Page Twenty ALL ABOUT MILK 

will take out the specks, and clarifiers will make milk look 
cleaner, but these processes do not improve the milk except 
in appearance. The bacteria and poisons cannot be filtered 
out nor separated out. The Commissioner of Health of Chicago 
estimated that twenty-five tons of dirt are brought in through 
the city milk supply every year. 

Does Milk Hide the Dirt? — Yes, because it is opaque. 
Try it for yourself. Add a teaspoonful of mud to a quart of 
milk. Mix it up. The milk will look as white and pure as 
before the mud was added. The opacity of milk covers a 
multitude of sins. 

What is the Dirt Test? — Filter a pint or a quart of milk 
through some clean white cotton, or through several layers 
of white cloth, and notice the brownish or blackish stain. 



o © 





1. 2. 

FOUR GRADES OP MILK AS INDICATED BY THE DIRT TEST. ONE PINT 
OF MILK WAS POURED THROUGH EACH OF THESE DISCS OF ABSORBENT 
COTTON, WHICH WERE PERFECTLY WHITE AT FIRST. THEY SHOW FOUR 
GRADES OF MILK, AS FOLLOWS: 1, PERFECTLY CLEAN; 2, SLIGHTLY DIRTY; 

3, dirty; 4, very dirty. 

What Does Most of the Dirt Consist of? — Mostly of cow 
dung; also of particles of dust from the air, bits of straw, parts 
of insects and trash of all kinds. 

What are the Objections to Dirty Milk? — Dirty milk spoils 
much more quickly than clean milk. Dirty milk is laden with 
bacteria, and may be harmful, especially to the tender infant. 

BACTERIA IN MILK. 
Does Milk Always Contain Bacteria? — All cow's milk 
bought upon the market contains some bacteria. Usually it 
contains a vast number — millions in every teaspoonful. Often 
they are innumerable — like the stars in the heavens. 



ALL ABOUT MILK Page Twenty-one 

Are These Enormous Numbers of Bacteria in Milk Harmful? 

— They are not necessarily harmful. Mere numbers need not 
frighten us. It is the kind of bacteria rather than the number 
that concerns us. Many of the bacteria in milk are our friends, 
not our enemies. 

Great numbers of bacteria are undesirable and unnecessary. 
They mean that the milk is dirty, or stale, or has not been kept 
cold. The number of bacteria, then, is a general index of the 
sanitary quality of the milk. 

Where Do the Bacteria Come From? — A few may be in 
the milk before it leaves the udder. For the most part they 
fall from the cow into the milking-pail during milking. They 
also fall into the milk with the dust from the air, or are washed 
in from dirty hands, or taken up from pails, bottles and any- 
thing else with which the milk comes in contact. 

Do Bacteria Grow in Milk? — Yes. They grow and multiply 
in milk at a rapid rate. Milk is a perfect food for germs. In 
twenty-four hours one single germ may have, billions of descen- 
dants. They love milk as much as the baby does. 

Is Milk Graded According to the Number of Bacteria? — 
Milk is graded according to the number of germs it contains : 

Certified milk Less than 10,000 bacteria in each thimbleful.* 

Inspected milk. . .Less than 100,000 bacteria in each thimbleful. 

Market milk Less than 1,000,000 bacteria in each thimbleful. 

In Boston the limit for market milk is 500,000; in New 
York, 1,000,000. 

What Effect Have Bacteria on Milk? — They cause it to 
decompose. Sometimes the milk ferments; sometimes it turns 
putrid. Fermentation and putrefaction are two different 
classes of decomposition, and both are due to bacteria, but to 
different kinds of bacteria. 

What is Nature's Danger Signal? — The souring and curdling 
of milk is called nature's danger signal. This is not so. Nature 
has no danger signal for milk. Curdled milk is not harmful — - 

*About 16 drops, or one cubic centimeter. 



Page Twenty-two ALL ABOUT MILK 

in fact, it may be beneficial. The dangers in milk cannot be 
seen with the unaided eye. 

What Usually Happens to Milk When Allowed to Stand? — 
Usually it turns sour and curdles. This is the normal way for 
milk to spoil. It is a special form of fermentation caused by 
lactic acid bacteria. 

CLEAN MILK. 

Is It Difficult to Keep Milk Clean? — No. It requires only 
intelligence and care. 

. How Long Will Clean Milk Keep? — Clean milk, kept cold 
and properly protected, shows very little change in three or 
even five or ten days. With special precautions it is possible 
to keep milk so that it may be shipped across the ocean and 
back again and still be in good condition. 

At the Paris Exposition in 1900, milk shipped all the way 
from New York, New Jersey and Illinois to France arrived 
there in good condition, and remained pure and sweet. The 
French farmers were dumbfounded, for they could not bring 
their milk more than one hundred miles nor have it in good 
condition for more than forty-eight hours. Major Alvord, 
in charge of the exhibit, found it no easy matter to convince 
the milk experts on the jury that the American milk was in 
its natural state, uncooked and undoctored. Nothing but 
cold and cleanliness were used to obtain such wonderful results. 

Is Clean Milk Also Safe? — It is naturally much safer than 
dirty milk, especially when the health of those who handle 
the milk is carefully supervised. 

Is Clean Milk Hard to Produce for the Market? — No, 
it requires only a little intelligence and reasonable care. With 
care, cleanliness and the use of ice, a satisfactory grade of milk 
may be sent to market by any farmer. Good dairy methods are 
more important than fancy barns and high-bred cattle. 

What are the Chief Points in the Production of Clean Milk? 
—Clean and healthy cows. Healthy milkers. Milk pails 
sterilized by scalding. Sterilized cans and bottles. Clean hands. 



ALL ABOUT MILK Page Twenty-three 

Why is So Much of the Milk Found on the Market Dirty 

and Unsatisfactory?— Because milk does not get the care and 
attention it deserves on most farms, especially on small farms. 

CERTIFIED MILK. 

How is Milk Classified? — There are only two classes of 
milk — good milk and bad milk. On the market, however, 
we find many different kinds of milk: (1) certified milk; (2) in- 
spected milk; (3) market milk. 

There is a growing tendency to classify all milk as raw milk 
or pasteurized milk. 

What is Certified Milk? — Certified milk is the very best, 
the very freshest, the very cleanest, the very purest and the 
very safest raw milk that it is possible to produce. It is milk 
of uniform composition, and of high quality, obtained by 
cleanly methods from healthy cows under special sanitary 
precautions. 

Who Certifies the Milk? — A medical milk commission. 

Why Does Certified Milk Cost So Much? — Because it 
requires a veterinary surgeon to test the cows with tuberculin in 
order to find out whether they have tuberculosis, and to examine 
them from time to time; because it requires a bacteriologist 
and also a chemist to analyze the milk; because a physician 
must supervise the health of the milkers; because the cows 
must be curried, groomed, and kept as clean' as race horses; 
because sterilizers must be provided for the bottles and pails; 
because skilled foremen must be in attendance to be sure the 
milkers wash their hands and wear clean clothes; because the 
milk must be bottled and iced at the dairy; because the con- 
struction, lighting and ventilation of the cow barns must be 
extra good and the water supply especially safe, and because the 
greatest care and attention must be constantly practised. 
Constant watchfulness is the price of safety. All this costs 
more money than the usual slipshod methods. Even with 
all these precautions certified milk will have about ten thou- 
sand bacteria in each thimbleful. 



Page Twenty-jour ALL ABOUT MILK 

What is Inspected Milk? — Inspected milk is a good grade 
of milk obtained from healthy cows by cleanly methods. In- 
spected milk is not quite as good as certified milk. It should 
not contain more than one hundred thousand bacteria in each 
thimbleful. 

What is Market Milk? — All milk that is neither certified 
nor inspected goes by the name of market milk. It is often of 
a poor quality and not suitable for infant feeding. 

MILK FOR BABIES. 
Is It Safe to Raise the Baby on Cow's Milk?— No. Ten 

bottle-fed babies die to one breast-fed baby. The chances are, 
therefore, ten to one against the bottle-fed baby. Mothers 
should always nurse their babies if possible and keep it up until 
the baby is six or nine months old. 

What are the Advantages of Breast Feeding? — Breast 
feeding is cheapest, simplest and safest. It needs no training 
and is less troublesome than tending to bottles. It is best 
for the baby and best for the mother. 

What are the Disadvantages of Bottle Feeding? — Bottle 
feeding requires skilled training to carry out safely; it requires 
skill and practice to modify the milk to suit the baby; it requires 
much more time and trouble than breast feeding. At best 
it is only a poor substitute. 

Modify and prepare cow's milk as we may, it cannot take 
the place of mother's milk. 

What Milk Should be Selected?— If the baby must be 
raised by hand, or weaned, select the best milk obtainable. 
Baby's milk should be certified or of equally high grade. It 
is poor economy to give the baby cheap milk. Cheap milk 
is apt to be poor milk. 

What Special Care Should be Taken? — Never warm the 
milk until feeding time. It is dangerous to keep milk warm 
or tepid for over half an hour; therefore never keep it warm 
in a thermos bottle. Cleanse and scald the bottle at once, and 



ALL ABOUT MILK Page Twenty-five 

again before filling. Meanwhile keep cold and covered. Do 
not use rubber tubing on the nursing bottle. Keep away flies. 

What Should the Mother Do in Case of Doubt?— Consult 
a physician, or go to the nearest milk station, dispensary or 
infant depot. Do not raise the baby according to the advice 
of neighbors. 

Can Many Babies be Saved?— Yes. There is much pre- 
ventable sickness and many unnecessary deaths. Impure 
milk is not the sole cause of this. Many babies can be saved 
by breast feeding, or the use of fresh, pure milk; .by care and 
cleanliness, and by following the advice of the doctor. Read 
the little pamphlet called "The Child," issued by the Metro- 
politan Life Insurance Company. 

Does Milk Sometimes Injure Adults Too? — Often. Many 
cases of typhoid fever, sore throat and other infections in 
grown-up people have been traced to contaminated milk. 

MILK AND DISEASE. 

What Diseases May be Due to Impure Milk? — Summer 
complaints of babies, tuberculosis, typhoid fever, diphtheria, 
scarlet fever, septic sore throat and some other unusual diseases, 
such as malta fever, foot-and-mouth disease, ' ' milk sickness, ' ' etc. 

Do Milk Epidemics Often Occur? — The following record 
of sickness due to milk during four years in the city of Boston 
answers this question: 

1907 Diphtheria 72 cases. 

1 907 Scarlet fever 717 cases. 

1908 Typhoid fever 400 cases. 

1910 Scarlet fever 842 cases. 

1911 Septic Sore Throat 2,064 cases. 

4,095 cases. 
More than four thousand cases of preventable sickness in 
one city in less than four years! All such milk epidemics are 
caused by raw milk, and never occur with properly pasteurized 
milk. Other cities have also been sufferers. Sanitarians 
know that milk is a common vehicle for the spread of infection 



Page Twenty-six ALL ABOUT MILK 

from country to town and back again from town to dairy, 
also from place to place in the country and in the city. 

How Often Does Milk Contain Germs of Tuberculosis? — 
About one sample out of every twelve of the milk found in a 
large city contains germs of tuberculosis. 

What is the Evidence? — The evidence from four typical 
American cities shows that, out of a total of 551 samples of 
milk examined, tubercle bacilli (tuberculosis germs) were 
found in 46, making a percentage of 8.3. This may be taken 
as the average percentage for the entire country. As a matter 
of fact, the percentage would be higher if our methods for the 
detection of the tubercle bacillus were more delicate. 

Are the Tubercle Bacilli in Milk Dangerous? — Yes, especially 
to children. About 25 per cent, of tuberculosis in children 
is of the bovine variety. That is, about one out of every four 
cases of tuberculosis in children is contracted from cow's milk. 

How Do Children Contract Bovine Tuberculosis? — Almost 
entirely through raw milk. There is comparatively little 
danger in meat, because tuberculosis of the muscles (flesh) is 
rare, and, furthermore, meat is usually cooked before it is eaten. 

Is There Any Difference Between Bovine Tuberculosis 
and Human Tuberculosis? — Bovine tuberculosis usually attacks 
the glands, and causes scrofula and enlargement of the lym- 
phatics of the neck and other parts of the body. Bovine 
tuberculosis is usually milder than human tuberculosis, although 
when it attacks the coverings of the brain (meningitis), or the 
bones of the spine (Pott's disease), the covering of the in- 
testines (peritonitis), or other vital parts, it proves serious and 
often fatal. Sometimes the tubercle bacilli spread rapidly, 
causing galloping consumption, which may result in death in a 
few weeks. 

Do Cattle Suffer Often from Tuberculosis? — Very often. 
Cows that are kept in poorly ventilated, sunless and unhygienic 
barns are very apt to develop tuberculosis, and under these 
conditions the disease spreads until it soon infects the whole 



ALL ABOUT M ILK 



Page Twenty-seven 



herd. Just so with men crowded together in dark, damp, 
poorly ventilated dwellings and workshops. 

How Can the Danger from Tuberculosis in Milk be Avoided? 
— There are two methods of prevention. The first is to eliminate 
tuberculosis from cattle, and the second to pasteurize the milk. 

Is It Easy to Eliminate Tuberculosis from Cattle? — It is 
almost as difficult to eliminate tuberculosis from cattle as it 
is from man, and, furthermore, it is going to take a very long 
time to do so. Therefore, until that time arrives our only 
protection is through pasteurization, which kills the tubercle 
bacilli and renders them harmless. 

Can Raw Milk Ever be Trusted? — If a herd of cows has 
been carefully tested with tuberculin, and these tests are 
repeated ever}' six months, and if the herd, furthermore, is 
examined from time to time by a skilled veterinary surgeon, 
then the milk from such a herd may, with all reasonable 
safety, be regarded as free from danger of conveying tubercle 
bacilli. 

Do Tubercle Bacilli Grow in Milk? — They do not grow and 
multiply in milk under ordinary circumstances. The tubercle 
bacilli found in any sample of milk are there, as a rule, because 
the cow has tuberculosis. 





TYPHOID GERMS. 



TUBERCULOSIS GERMS IN SPUTUM. 



TYPHOID FEVER. 
Does Milk Convey Typhoid Fever? — Milk is rather fre- 
quently responsible for cases of typhoid fever, much more often 
than other raw food, such as oysters, celery and watercress. 



Page Twenty-eight ALL ABOUT MILK 

Do Typhoid Bacilli Grow in Milk? — They grow very well. 
Milk may be teeming with myriads of typhoid bacilli in every 
drop and yet the milk has not been changed in appearance, 
color or taste. There is, therefore, no way of telling whether 
a glass of milk that seems sweet, good and wholesome does or 
does not contain this danger. 

How Do Typhoid Bacilli Get into the Milk? — Cows do not 
have typhoid fever. The disease is peculiar to man; therefore 
typhoid bacilli always get into the milk from man and not 
from the cow, as is usually the case with tubercle bacilli. 

Is it Necessary for the Milker to be 111 with Typhoid Fever 
in Order to Infect the Milk? — Not at all. The milker may be 
a bacillus carrier — that is, in perfectly good health and never- 
theless discharging typhoid bacilli. 

Where do the Typhoid Bacilli Usually Get into the Milk? — 
Usually on the farm, sometimes at the city dairy, occasionally 
on the railroad in transportation, sometimes at a corner grocery 
store, and sometimes in the home. 

Is the Danger from Typhoid Carriers Serious? — Bolduan 
estimates the startling total of 90 to 120 typhoid carriers 
which probably menace the milk supply of New York City. 
He also estimates that from 300 to 400 cases of typhoid fever 
each year come in contact with the milk supplied to New York 
City. This estimate is based upon the fact that about 200,000 
persons come in more or less intimate contact with the milk 
from over 40,000 dairy farms, producing 1,600,000 quarts of 
milk used in New York City every day. Approximately the 
same proportions hold for smaller cities and towns. 

SCARLET FEVER. 

Can Milk Convey Scarlet Fever? — It does. An epidemic 
due to infected milk occurred in the spring of 1910 in and 
around Boston, with a total of 482 cases. As soon as this 
milk was pasteurized the epidemic was checked, and three days 
following came to an end. 



ALL ABOUT MILK Page Twenty-nine 

Does Scarlet Fever Come from the Cow or from Man? — 

There is a suspicion that some of the diseases of the cow, 
caused by a little germ known as the streptococcus, may cause 
a disease resembling scarlet fever in man. As a rule, however, 
the milk becomes contaminated from human sources. 

Is It Easy to Keep Scarlet Fever Out of Milk? — It is very 
difficult, because the disease is sometimes so mild that it is 
hard to recognize the cases. These are known as "missed 
cases," but these mild or missed cases are just as contagious 
as the severe and fatal cases. Sometimes the scarlet fever 
virus continues to be discharged from the throat or from a 
running ear a long time after convalescence. 

DIPHTHERIA AND SORE THROAT. 

What are the Facts Concerning Diphtheria? — Diphtheria 
bacilli also grow well in milk without changing its taste, odor 
or color. Bacillus carrying is common in diphtheria. Nu- 
merous outbreaks of diphtheria have been traced to infected 
milk. 

May Septic Sore Throat be Caused by Milk? — A disease 
variously known as septic sore throat or tonsilitis, or quinsy, 
is sometimes conveyed by milk. Septic sore throat, due to 
infected milk, is well known in Great Britain, but the first 
outbreak to be recognized in this country occurred in May, 1911, 
in Boston. Since then outbreaks have been reported from 
Chicago, Baltimore, Concord (N. H.) and many other places. 
The disease is evidently spreading. 

Is This Form of Sore Throat Serious?— It is serious on ac- 
count of the complications, which sometimes result fatally. 
It is a disease that is especially liable to affect adults. 

Are Fresh Milk Products Also Apt to be Dangerous? — 
Yes. Cream, ice cream, cottage cheese and other fresh-milk 
products may convey infective agents if present in the milk 
from which they are made. 



Page Thirty ALL ABOUT MILK 

PASTEURIZATION. 

What is Pasteurization?- — Pasteurized milk simply means 
heated milk. In the language of the kitchen, it means par- 
boiling or "scalding." It is not necessary to boil milk in order 
to pasteurize it; if you have no thermometer it is advisable 
to bring it to a boil in order to be sure that the harmful germs 
are killed. 

After the milk is heated it must be suddenly chilled and kept 
cold. This is an essential part of the process of pasteurization. 

The word pasteurization is used in honor of the great 
scientist, Pasteur, who discovered the process. 

What is the Proper Temperature and Time for Pasteuriza- 
tion? — The milk should be heated to 148 degrees Fahrenheit 
for 30 minutes. A lower temperature or shorter time may not 
kill the bacteria. A higher temperature or longer time is not 
necessary. 

What is the Object of Pasteurizing Milk? — There is only 
one object, and that is to destroy the harmful bacteria. 

Does Pasteurization Destroy All Bacteria in Milk? — No, 
only harmful and frail varieties of bacteria. The harmless and 
hardy forms survive, and will continue to grow and multiply. 
Therefore, pasteurized milk turns sour and curdles in the same 
way that unheated milk spoils. 

Why is Rapid Cooling Important? — The milk should be chilled 
at once after heating and kept cold, because if allowed to cool 
slowly it remains at blood heat for several hours. This is the 
best temperature for the growth and multiplication of bacteria 
and their poisonous products. 

Does Pasteurization Improve the Milk? — Pasteurization 
neither improves nor harms the milk itself. Poor milk is not 
any better because it has been pasteurized. It would avoid 
confusion if pasteurized milk were simply called heated milk, 
for that is all it is. 

Is Pure Milk Better Than Purified Milk?— It is; but it is 
so difficult to get pure milk that our only real safety lies in 



ALL ABOUT MILK Page Thirty-one 

pasteurization. So long as raw milk is apt to be dangerous 
milk, our only protection lies in heating the milk, thereby 
killing the germs of tuberculosis, typhoid fever, diphtheria, 
scarlet fever, septic sore throat, etc. 

How Does the Sanitarian Regard Pasteurization? — As a 
public health safeguard. It corresponds to the filtration or 
purification of water. Sanitarians unanimously favor pasteur- 
ization. 

How Can the Efficiency of Pasteurization be Safeguarded? 
— Only by official control. Pasteurization is too important 
a public health measure to leave to the caprice of each indi- 
vidual dairyman. The process should be guarded by health 
laws and regulations. 

Does Pasteurized Milk Require Greater Care Than Un- 
heated Milk? — Pasteurized milk must be handled at least as 
carefully as raw milk. It may become infected after pasteuriza- 
tion. Bacteria grow even more rapidly in heated milk than in 
fresh, raw milk. All milk, whether raw or heated, should be 
kept covered, cold and clean. 

What is the Best Method of Pasteurizing Milk? — For 
family use it is advisable to obtain milk already pasteurized 
by a trustworthy dairy. It is cheaper, safer and better to heat 
the milk by wholesale in a large plant with competent super- 
vision than to depend upon each household heating its daily 
supply. If water needs purification it is filtered at a central 
station and not left for each individual kitchen. 

How Can Milk be Pasteurized in the Home? — The best 
and simplest method of pasteurizing milk for infant feeding is 
in the Straus pasteurizer. Milk of a good quality is placed 
in individual nursing bottles and heated according to directions 
given below. 

What is the Best Method of Pasteurizing Milk for Family 
Use? — The easiest way to pasteurize milk for family use is 
to heat it in a double boiler, such as a rice-boiler, for three- 
quarters of an hour, and then to chill it quickly. 



Page Thirty-two 



ALL ABOUT MILK 



The Straus pasteurizer consists of a pail for water and a 
receptacle for the bottles of milk. It is used as follows: 

After the bottles have been thoroughly cleaned they are placed in the 
tray (A) and filled with the milk or mixture used for one feeding. Then 
put on the corks or patented stoppers without fastening them tightly. 

The pot (B) is now placed 
on the wooden surface of the 
table or floor and filled to 
the supports (C) with boiling 
water. 

Place the tray (A) with 
filled bottles into the pot (B) 
so that the bottom of the tray 
rests on the supports (C), and 
put cover (D) on quickly. 

After the bottles have 
been warmed up by the steam 
for five minutes, remove the 
cover quickly, turn the tray 
so that it drops into the water, 
replace the cover immedi- 
ately. This manipulation is 
to be made as rapidly as pos- 
sible to avoid loss of heat. Thus it remains for twenty-five minutes. 
Now take the tray out of the water and fasten the corks or stoppers 
air-tight. Cool the bottles with cold water and ice as quickly as possible, 
and keep them at this low temperature until cold. 
. Use the milk from the bottles and do not pour it into another vessel. 
The milk should not be used for children later than twenty -four hours 
after pasteurization. 

Emphasis is laid on the fact that only fresh, clean milk, which has been 
kept cold, should be used. 

What is the Great Advantage of Pasteurization? — Pas- 
teurization saves lives and prevents sickness. 

Is Pasteurization an Ideal? — It is usually regarded only as 
a temporary expedient, that is, as the simplest, cheapest and 
least objectionable method of making raw milk safe. 

Should Babies be Given Pasteurized Milk? — Babies should 
have mother's milk; there is no adequate substitute. If 
mother's milk is not available, babies are entitled to the best 




Fio. 72. — Straus Home Pasteurizer. 



ALL ABOUT MILK Page Thirty-three 

and freshest cow's milk that can be obtained. Whether such 
milk is to be modified, pasteurized or otherwise treated is a 
question for the doctor to decide in each individual case. 

Unless very sure of the supply, the doctor will usually not 
take chances, and advise pasteurized milk for baby, especially 
during the summer time. 

Is Pasteurized Milk Less Nutritious? — Pasteurized milk is 
just as digestible and just as nutritious as raw milk. 

Is It Necessary to Pasteurize All Milk? — All milk that can- 
not be certified as clean, fresh and SAFE should be pasteurized. 

THE SOLUTION OF THE MILK PROBLEM. 
What is the Solution of the Milk Problem? — Inspection 
and pasteurization. We need inspection to keep milk clean; 
we need pasteurization to render milk safe. Inspection goes 
to the root of the problem and helps bring us cleaner, better, 
fresher and safer milk. Inspection, however, has limitations. 
These limitations may be guarded against by pasteurization; 
hence a milk supply that is both supervised and pasteurized is 
the only satisfactory solution of the problem. 



Reference: "The Milk Question," by M. J. Rosenau, published by 
Houghton, Mifflin & Co., 1912. 



LIBRARY OF CONGRESS 



ilium 

000 895 701 • 




By LORADO TAFT 

Courtesy Infant Welfare Society of Chicago. 



MM 
N573 



